As I approach life in my 50th year, my body has tangibly slowed down compared to my earlier years as an energetic university student. Grey hairs have started sprouting randomly, and my exercise tolerance isn’t what it used to be. However, I’m determined to stave off those dreaded ‘man-boobs’.
I even began to ponder whether I was prematurely aging, and hypochondriasis aside, I couldn’t help but wonder if there was any truth behind the somewhat kaleidoscopic and mystical physiological concept known as “male menopause”.
Therefore, I decided to search for reputable studies that may assist me.
Is Male Menopause a Misnomer?
As I discuss the debate surrounding “male menopause,” I must first clearly understand what we’re discussing.
Contrary to popular belief, “male menopause”, also known as andropause, isn’t a universally accepted medical term. The phrase has also been bandied around the media and has become somewhat of a misnomer in my experience.
And like the hair on my head, the debate and research among scholars and healthcare professionals is full of grey areas.
Even the hunt for credible journal articles on my sound, evidence-based medical database led to several dead ends.
Unlike female menopause, a natural biological process characterised by cessation of menstruation for 12 consecutive months and a significant drop in oestrogen levels, the concept of “male menopause” is somewhat controversial.
Males assigned at birth (MAAB) do experience a reduction in testosterone levels as they age. Testosterone is a vital hormone responsible for various bodily functions. It is responsible for male sexual characteristics, maintains muscle mass, governs libido and regulates mood.
According to the Mayo Clinic1, a man’s testosterone levels decline on average about 1% a year after age 40, so not as precipitously as female sexual hormones like estrogen and progesterone.
As this decline doesn’t occur abruptly, most men don’t experience the complete “shutdown” of their reproductive systems that women do.2
The Reality of the “Andropause Angle”
While the term “male menopause” may be somewhat inaccurate, the underlying phenomenon it refers to is very real from a medical angle.
The condition is more accurately described as late-onset hypogonadism (LOH), a syndrome characterised by the gradual decline in testosterone levels in middle-aged and older men.
LOH is far more prevalent in older men, obese men, and men with Type 2 diabetes, which can significantly impact their quality of life3.
Symptoms can be non-specific and include fatigue, depression, irritability, reduced libido, erectile dysfunction, hot flashes, and cognitive difficulties.
Many of these signs and symptoms may also be associated with normal testosterone levels, so unless astute health professionals suspect the condition, necessary blood tests will not be performed.
Diagnosing LOH is further compounded by the fact any busy family physician does not routinely order these tests.
Having said that, if testosterone levels are found to be at sub-optimal levels, replacement hormone therapy is available under strict guidance by qualified doctors.
Aging with Agility: Is Declining Testosterone Inevitable?
Despite the somewhat gloomy picture I have painted so far, it’s essential to realise that declining testosterone is not an inevitable part of aging.
While it’s true that testosterone levels tend to decrease as men age, this isn’t a universal rule.
Many factors can contribute to reduced testosterone levels, including poor diet, excessive alcohol use, lack of exercise, stress, and underlying health conditions.
According to Medical News Today, many healthy lifestyle changes could help maintain or even boost testosterone levels in men as they age4.
Empowering Men: Strategies for Hormonal Harmony
Viewing “male menopause” not as a threat but as a call to action empowers men approaching their fifth decade and beyond like myself.
It is self-evident that prioritising regular exercise, a balanced diet, sufficient sleep, social connections, and stress management supports healthier testosterone levels.
Embracing the aging process and making self-care decisions will allow men to age gracefully with even more strength and vitality.
Lifestyle changes and regular communication with a healthcare provider can help manage these challenges.
However, many men may avoid seeking medical attention due to a combination of self-assurance that their condition will resolve spontaneously and fear of potential negative diagnoses or outcomes. This hesitancy could arise from a desire to avoid inconveniencing doctors and a sense of vulnerability.
Thus, they may turn to online resources, in private, like “Dr Google,” which are often full of dis/misinformation, to uphold a “superhero” image.
Despite these challenges, though, and with the proper support and mindset, every step towards better health is a victory, however small it may be.
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I acknowledge First Australians, the traditional custodians of the country throughout Australia. We recognise their continuing culture, their contribution, and their connection to land, waters, and community, and we pay our respects to elders past, present, and emerging.
I declare I have no conflicts of interest in my writing.
Dr Surrinder Paul Singh MB BS (London, UK) BSc. (Primary Health Care)
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I have never realised that men also struggle from “menopause”, and even from hot flashes! Thank you for the article. Now I have one more topic to discuss with my friends at age of 50.